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Epic waits, 'gaming' the books at some VA hospitals, testimony reveals

Some veterans are waiting six months to see VA doctors to fix their broken dentures or artificial knees and at least two veterans died last year from diseases “due to delay in care” at their local VA hospitals, according congressional testimony delivered Thursday.

Meanwhile, staffers at several Veterans Affairs medical centers were found to have rigged computer records to make it appear as though there are little or no wait times for ex-service members when, in reality, backlogs for veterans needing exams and treatment can span six to eight weeks, additional testimony revealed.

“Delayed care is denied care,” said Rep. Ann Kirkpatrick, D-Ariz., during a House oversight hearing held to investigate why most veterans must wait 50 days on average to schedule initial exams with VA doctors. Kirkpatrick spoke of one Iraq veteran in her district who required more than six months to book his initial consultation with a VA mental health provider.

“Veterans should not have yet another hoop to jump though. Access to health care should be easy to schedule,” Kirkpatrick said.

With the Department of Veterans Affairs already nine months behind in meeting disability claims, the fresh anecdotal evidence of long veteran-patient waits prompted Rep. Mike Coffman, R-Colo., to chastise the VA Deputy Under Secretary William Schoenhard: “You’ve been here, in this position since 2009. You came in (and) the system was in chaos and not serving the veterans community. You’ve been there. You haven’t made a difference. And I have no reason to think that under your leadership, unfortunately, this job is going to get done.”

Coffman also waved a handful of VA records documenting the deaths in May of 2012 of two veterans, one in Georgia and one in South Carolina — both of whom were ill and awaiting consultations with VA doctors. “So by your own internal documents there are issues concerning the quality of care related to timeliness and, unfortunately, the loss of life unnecessarily of veterans. That’s particularly alarming,” Coffman said.

Earlier in the hearing, Schoenhard expressed his regret over any reported “breakdown in care,” adding that “any veteran who goes without timely care is one veteran too many in terms of our commitment to serve those who served us.” He testified that the VA is working to tighten its appointment system by better meshing its administrative and clinical functions and ensuring “more robust training of our staff who schedule these patients.”

But equally troubling to members of the House Veterans’ Affairs subcommittee: reports of VA employees who — as Coffman described — “game the numbers” to deceptively make VA patient-wait times appear shorter. The Government Accountability Office discovered such altered computer records during recent inspections at four VA medical centers, a GAO official testified Thursday.

“Some staff told us they changed medical-appointment desired dates so that the wait times aligned with VA’s related performance goals ... We heard this across several facilities,” testified Debra A. Draper, director of health care at the GAO.

Draper testified that at one primary VA clinic, GAO investigators learned that a scheduler had changed dates (in a computer) “to show there were no long wait times. At another specialty care clinic, we heard providers were changing (appointment) dates to make sure their data showed they were within the (desired) 14-day timeline of the VA. We also went to one specialty clinic (where) it showed a zero-day wait time (when) ... in reality there was a six-to-eight week backlog, at least.”  

Asked by Kirkpatrick whether those VA schedulers “were unduly influenced” by VA brass to purposely tweak the appointment records, Draper replied: “We weren’t specifically told they were directed by management. The current (software) situation provides ample opportunity to change dates, whether intentional or not, to reflect the results you want to achieve.

“(However), these measures are included in VA’s budget submissions and in VA’s annual performance and accountability report,” Draper added. “So there’s a lot of incentive around these measures.”